SENATE BILL 41
49th legislature - STATE OF NEW MEXICO - first session, 2009
INTRODUCED BY
Dede Feldman
AN ACT
RELATING TO HEALTH CARE REFORM; AMENDING A SECTION OF LAWS 2008 TO REFLECT ADDITIONAL GOALS FOR THE HEALTHY NEW MEXICO TASK FORCE.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
Section 1. Laws 2008, Chapter 86, Section 1 is amended to read:
"TEMPORARY PROVISION--HEALTHY NEW MEXICO TASK FORCE--MEMBERSHIP--DUTIES.--
A. By July 1, 2008, the secretary of health shall convene a healthy New Mexico task force to devise a comprehensive five-year strategic plan for preventing disease and managing chronic conditions for public and private programs. The healthy New Mexico task force shall report on its strategic plan to the interim legislative health and human services committee by June 30, 2009. The healthy New Mexico task force shall work in conjunction with the national institutes of health, the New Mexico health policy commission, the New Mexico medical society or other boards, commissions, departments, agencies, authorities, organizations and persons necessary to provide appropriate expertise to devise the strategic plan. The strategic plan shall contain recommendations for reducing overall demand for high-cost medical and behavioral health treatments, thereby reducing or moderating the increase in health care costs.
B. The healthy New Mexico task force's strategic plan shall include the following features:
(1) a plan for hiring the services of persons specializing in disease management to control costs and encourage healthy lifestyles in the state employees group benefits self-insurance plan, with the objective of guaranteeing savings to the state employees group benefits self-insurance plan;
(2) recommendations on implementing the primary care case management project to pay medicaid
fee-for-service providers a capitated rate for managing patients' health status and treatment, and the healthy New Mexico task force shall recommend the areas of the state where this project can be implemented cost effectively;
(3) recommendations on requirements for private health insurers and group health plans to reward providers for controlling chronic diseases and chronic conditions; [and]
(4) recommendations for funding and implementing a pilot program to integrate prevention, early intervention and case management in one targeted community that the healthy New Mexico task force has identified as being underserved as relating to health care services. The pilot program shall focus especially, but not exclusively, upon diabetes and obesity prevention, intervention and case management; and
(5) recommendations for designing and implementing a comprehensive pay-for-performance system whereby providers receive financial incentives for measurable improvements in the health of their patients, including recommendations for quality evaluation and measurement protocols and for increasing community support for quality health care outcomes.
C. As used in this section:
(1) "chronic condition" or "chronic disease" means a disease or condition that has a prolonged course, that does not resolve spontaneously, involves functional impairment or disability for which a complete cure is rarely achieved and that may require ongoing medical care;
(2) "chronic condition management" or "chronic disease management" means a system of coordinated health care interventions and communications for individuals with chronic diseases or chronic conditions, including significant patient self-care efforts, system supports for provider and patient relationships and a plan of care emphasizing prevention of complications utilizing evidence-based practice guidelines, patient empowerment strategies and evaluation of clinical, humanistic and economic outcomes on an ongoing basis with the goal of improving overall health; and
(3) "disease management" means health care services, including patient education, monitoring, data collection and reporting, designed to improve health outcomes in defined populations with selected chronic diseases."
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